Five-year survival following oesophageal cancer resection: Psychosocial functioning and quality of life

Oesophageal cancer produces debilitating symptoms such as dysphagia, reflux and fatigue. In addition the prognosis is poor with five-year survival following resection estimated at 15%. It is important, therefore, to identify whether survival alone provides good quality of life (QOL) for these patients or whether psychosocial and physical outcomes of oesophageal resection further impair functioning. Thirty-seven of 75 patients (46%) surviving five years or more following oesophageal resection were assessed using the European Organisation for Research and Treatment (EORTC) QLQ-C-30, the EORTC QLQ-OES24 and the Medical Outcomes Study SF-36. These measures were chosen as they reflected valid and reliable measures of QOL important for differentiating global and specific outcomes of oesophageal cancer. Thirty-seven healthy controls were matched to the patient group to compare QOL. Low levels of symptoms were reported by the majority of patients, although a small proportion of patients experienced severe symptoms specifically fatigue, pain, dysphagia and anxiety. However, when QOL was compared with a healthy population, analyses indicated that there was a trend to lower physical functioning. This study indicates that there is good QOL following oesophageal resection for the majority of patients which is comparable with the general population. In addition, the use of a disease-specific questionnaire such as the EORTC QLQ-OES24 was useful for identifying future oesophageal cancer concerns. This research also indicates that psychological interventions for patients with physical and emotional needs are also necessary for successful rehabilitation.